#26: MD vs. DO, DO vs. MD. Stop it.

I met up with the friend from post #4. Let's call her Mandy (not the real name of course). She's applying to med school right now and was asking about the application process and med school in general. At one point during the conversation, Many asked, "Would you have considered applying to DO schools?" My response, "No. Definitely not." It was not because I do not respect DO schools. It was because of what I believe to be hypocritical to my beliefs of what medicine is about: care for the patient. Let me explain.

This post may be a Pandora's box, but let's open it to discussion. Don't flame me, please.

Hold on, now. Chill out for a minute before you reach for the pitchforks and torches. I understand and know that this whole MD/DO issue has been going on for decades. It's a touchy subject among the professionals, med students, and even pre-meds.

In the States, we have two types of med school: Allopathic and Osteopathic. Allopathic med schools are the ones that grant MD (Doctor of Medicine) degrees. Osteopathic med schools grant DO (Doctor of Osteopathic Medicine) degrees.

First, as an MD student, let me say that I respect DO physicians, students, and interested pre-meds. I wholeheartedly respect what they do, study, and aspire to become. DO colleagues have the same goal as MDs: to serve, treat, and care for patients. Both take the Hippocratic Oath. Both have the same medical responsibilities to patients.

Second, I understand that MD and DO schools have different teaching philosophies as allopathy and osteopathy have different medical philosophies. MD students have to take the USMLE and DO students have to take the COMLEX. DO students also learn Osteopathic Principles and Practices (OPP) and Osteopathic Manipulative Medicine (OMM) and Osteopathic Manipulative Therapy (OMT).

I have absolutely no issue with different degree, different medical philosophies, and different teaching philosophies. Historically, Dr. Still broke away from the MD crowd to establish osteopathic medicine. That's absolutely marvelous in my mind. Hey, Dr. Still clearly had a different medical ideology and he had every right to teach it. Coolios.

With respect to core basic medical science courses and a huge overwhelming majority of clinical courses/rotations, MD and DO students learn the exact same material. The only different is the addition of OMM, OMT, and OPP and the emphasis of osteopathy in other courses at osteopathic schools.

But, the rift between the MD and DO communities has been tense although it is calmer now. I have heard and talked about the disdain one group for the other whether it be about standardized exam scores, application stats, education styles, jealousy, paid grades, residency site competitiveness, whatever. I do not even want to go into comparing the prestige battle about medical schools and residency sites.

What I have a problem with is this: DO students can take the USMLE in addition to COMLEX and apply for allopathic residency positions. However! However, MD students cannot take the COMLEX in addition to USMLE and apply for osteopathic residency positions. Look, I understand that MD students cannot take the COMLEX because they do not have the education in OMM, OMT, and OPP. But, allopathic residency hospitals have extended their welcome to DO graduates. Yet, DO residency hospitals have not reciprocated. I understand that OMM, OMT, and OPP and the osteopathic education in general give another dimension to DO physicians and graduates that the MD counterparts do not have.

Above the disparity in applying for residency, I have a bigger problem with this: Since all physicians, regardless of degree or education, are dedicated to care and treat patients, why can't we all just be doctors? One type. Make one medical doctor degree? If you got osteopathic education and training, then why not make it an additional credentials to the end of your name? There was a report out there that states that DO physicians use OMM/OMT about 5-15% of the time. (Can someone please look for the stats of this?) Do those percentages really make that much of a huge difference to cause a division in the physician community?  

Question
So, here are my concluding questions: If DOs historically wanted a split, then stick with your guns. If DOs now want to work alongside MDs, then reciprocate by opening your residency positions to MDs too. If you got osteopathic education and training, great! You're a physician, too. You're out there to treat and care for patients, too. With the healthcare crisis bubble about to burst, why care if you are DO or MD? Why not just care about being a physician? Why not train as many physicians as possible and put aside the schoolyard tomfoolery? If you got osteopathic skills, use it, and as I suggested, tag on the osteopathic credentials to your embroidered white coat.

Think about the patient, not about which kind of physician you are. Really, like, for real, which of the following sounds better to you if you heard it from a patient?

a) My physician is awesome!
b) My DO/MD physician is awesome!

Since I'm in the MD community, I will honestly admit that I am MD biased. Really, DOs, it is time to open up your residency doors. Or better yet, MDs and DOs, can we all get along? Medicine has advanced a very long way. Heck, even medical education for both allopathy and osteopathy has advanced with all the integrative clinical education in the first two didactic years. We as a community of physicians should too.

#25: Importance of a Physician

This post is not about seeking self-pity or even pity. It's not about being self-absorbed or demanding recognition. Take it as an explanation of part of why I want to become a physician.

We expect our physicians to be smart, charismatic, efficient, understanding, accommodating, prompt, careful, considerate, communicative, accessible, honest, dignified, altruistic, confidential, attentive, dedicated, hardworking, caring, informative, right, proactive...the list goes on. Those are a lot of expectations. It's rightfully so that we expect so much from physicians. And, physicians know this. They took the Hippocratic Oath the moment they graduate from medical school. At my school, I took the Hippocratic Oath at my White Coat Ceremony in my first year.  Physicians understand not only their duty, but their value to their patients.

Why so many expectations? Why are they justified? Because physicians don't necessarily handle things in your life. Physicians handle your life. Not your money, not your car, not your house, not your work, not your schedule. You. Your money can come and go. But, you, you can't. You can't die and come back. (Well, maybe give science and research a few more years...)

Without you, you can't have the things in your life. Imagine not being able to buy a home, marry the person of your dreams, drive your favorite car, read a book on the porch, travel the world, see your parents or kids, talk with your friends, walk, occasionally indulge in your sins and vices, live long enough to see your grandkids, have sex, and all the other little joys of life.

You seek physicians when you're in pain, sick, and/or distressed whether it's because of your volition or of the encouragement of others or when it's your last resort or whenever you want to. Physicians are bound by an oath to treat and care for any patient who seeks them. Now, when I say treat and care, physicians must consider the medical benefits and costs, your personal beliefs and feelings, resources available, and ethical principles. All of this biosocioethical consideration on top of the intellectual demands of figuring out what is medically wrong with you.

The burden of integrating the nuts and bolts of scientific medicine for a diagnosis, the patient's feelings and views, and the physician's own feelings and views can be overwhelming at times. Treatment and care encompass all these factors, which ultimately leads to handling your life. It's not easy. Being a physician is extremely and exorbitantly demanding.

I wouldn't want to be anything else...but, check back with me when I actually have that MD title if I survive the onslaught of 2nd year.